原发性细胞癌伴微血管侵犯的危险因素分析

Analysis of risk factors of hepatocellular carcinoma with microvascular invasion

目的探讨原发性肝细胞癌（hepatocellular carcinoma，HCC）伴微血管侵犯的危险因素。方法回顾性复习134例HCC切除术病人的临床资料，分析微血管侵犯与HCC病人临床理资料的相关性。结果134例HCC中46例（34．3％）有微血管侵犯。单因素分析显示肿瘤体积〉3cm、包膜缺失、组织分化恶性程度高、血清AFP阳性（〉20ng／ml）与微血管侵犯显著相关（P〈0．05），而病人年龄、性别、肝炎病毒感染、是否合并肝硬化、组织学类型与微血管侵犯之间无明显相关性。微血管侵犯与HCC大体卫星结节的形成成显著相关（P=0．001）。结论微血管侵犯是HCC的常见恶性事件，肿瘤体积〉3cm、包膜缺失、组织分化恶性程度高、血清AFP阳性是微血管侵犯的危险因素。

Objective To analyze the risk factors of hepatocellular carcinoma （HCC） with microvascular invasion. Methods The clinical data of 134 cases of HCC with microvascular invasion received liver resection in our hospital were retrospectively analyzed. Results Microvascular invasion was found in 46 cases （34.30%）. Univariate analysis showed that the tumor size larger than 3 cm, no encapsulation, high histological grade （G3 ＋ G4） and serum AFP positivity （〉20 ng/ml） were significantly correlated to microvascular invasion （P〈0.05）. The age, sex, hepatitis virus infection, accompanying cirrhosis background or histological type was not associated with the mierovascular invasion. The microvaseular invasion was markedly correlated with increased occurrence of macroscopic satellite nodules （P=0. 001）. Conclusions The microvascular invasion is a frequent event in HCC patients. Tumor size larger than 3 cm, no encapsulation, high histological grade and serum AFP positivity are risk factors of HCC microvascular invasion.